Value And Relevance Of Retinol Binding Protein For Early Diagnosis Of Type 2 Diabetic Nephropathy

Objective:To explore the diagnostic value and correlation of retinol-binding protein(RBP)in the early stage of type 2 diabetic nephropathy by analyzing and comparing the variation of serum retinol-binding protein(RBP)in different stages of diabetic nephropathy.Methods: According to the preset inclusion and exclusion criteria,the clinical data of135 patients with type 2 diabetes who were hospitalized in the Endocrinology Department of Jilin Provincial People’s Hospital from August 2021 to November 2022 were collected and sorted out.They were divided into 3 groups according to the urinary albumin/creatinine ratio(UACR): Simple diabetic nephropathy group(n=43,UACR<30mg/g),early diabetic nephropathy group(n=49,30mg/g≤UACR<300mg/g),clinical diabetic nephropathy group(n=43,UACR≥300mg/g).By reviewing medical records,clinical data such as gender,age,height,weight,BMI,HbA1c,TC,TG,LDL-C,HDL-C,Scr,UA,CysC,RBP,UACR and eGFR of the three groups of patients were recorded and sorted out,and analyzed by SPSS21.0 statistical software,so as to draw a conclusion.Results:1.The differences of HbA1c,TC,TG,CysC,RBP,UACR and eGFR among the three groups were statistically significant(P<0.05).RBP level of simple diabetic group < early diabetic nephropathy group < clinical diabetic nephropathy group.2.There were no significant differences in gender,age,height,weight,BMI,LDL-C,HDL-C,Scr and UA among the three groups(P >0.05).3.Spearman correlation analysis showed that HbA1 c,TC,TG,CysC and RBP were positively correlated with UACR,and the correlation between RBP and UACR was the highest(γ=0.571,P=0.000).eGFR was negatively correlated with UACR(γ=-0.302,P=0.000).4.Curve regression analysis showed that RBP had a significant positive effect on UACR,and the adjusted R2 value was 0.290.5.ROC curve analysis showed that the area under the curve(AUC value)of RBP was 0.771(95%CI 0.667～0.866,P=0.000).The optimal cut-off value was 37.45mg/L,the sensitivity was 85.7%,and the specificity was 56.2%.Conclusion:1.The RBP level of early diabetic nephropathy patients was higher than that of simple diabetic patients,but lower than that of clinical diabetic nephropathy patients.2.There was a good correlation between RBP and UACR in diabetic nephropathy patients,which had a significant positive effect on UACR,and could explain 29.0% of the change of UACR.3.The sensitivity and specificity of RBP in predicting early diabetic nephropathy were 85.7% and 56.2%.4.RBP can be used as one of the biomarkers for the diagnosis of early diabetic nephropathy.